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THEW I SDO M O FTRAUMA .

COM

COMPANION BOOKLET
COMPANION BOOKLET

1. TRAUMA DEFINITIONS

“Trauma is a psychic wound that


hardens you psychologically and
then interferes with your ability to
grow and develop. It pains you
and now you’re acting out of pain.
It induces fear and now you’re
acting out of fear. Trauma is not
what happens to you, it’s what
happens inside you as a result of
what happened to you. Trauma is
that scarring that makes you less
flexible, more rigid, less feeling
and more defended.”

— Gabor Maté

“Trauma is an inability to inhabit “Trauma can be anything that


one’s body without being pos- happens too much, too fast, too
sessed by its defenses and the soon, too long coupled with not
emotional numbing that shuts enough of what should have
down all experience, including happened that was resourcing.“
pleasure and satisfaction.“
— Resmaa Menakem
— Bessel van der Kolk

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2. TRAUMA SYMPTOMS

When trauma is triggered, we may regress


into primal states of fear, react aggressively,
or become paralyzed and not be able to as-
sess the level of threat. Below are examples
of the way trauma symptoms can look like. (*)

• Hyper-arousal: Increased heart rate, rapid or


difficulty breathing, cold sweats, tingling,
muscular tension

• Constriction in body and narrowing of perceptions

• Disassociation or Denial

• Feelings of helplessness, immobility and freezing

• Hyper vigilance

• Intrusive imagery or flashbacks

• Extreme sensitivity to light and sound

• Hyperactivity

• Exaggerated emotional and startle responses

• Nightmares and night terrors

• Abrupt mood swings: Rage reactions or temper tan-


trums, frequent anger or crying
• Shame and lack of self-worth

• Reduced ability to deal with stress

• Difficulty sleeping

• Panic attacks, anxiety and phobias

• Mental blankness or spaced-out feelings “[As trauma occurs], our


• Avoidance behavior: Avoiding places, moments, ac- automatic danger signals
tivities, memories or people are disturbed and we
• Attraction to dangerous situations become hyper- or
• Addictive behaviors: Overeating, drinking, smoking, hypoactive; aroused or
drugs, etc. numbed out.”
• Exaggerated or diminished sexual activity

• Amnesia or forgetfulness — Bessel van der Kolk

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• Inability to love, nurture or bond with other individuals

• Fear of dying or having a shortened life

• Self-mutilation

• Loss of sustaining beliefs (Spiritual, religious, inter-


personal)
• Excessive shyness

• Diminished emotional responses

• Inability to make commitments

• Chronic Fatigue or very low physical energy

• Immune system problems

• Psychosomatic illnesses: headaches, migraines,


neck and back problems, chronic pain, asthma, skin
disorders, digestive problems

• Depression and feelings of impending doom

• Feelings of detachment, alienation and isolation (liv-


ing dead syndrome)
• Reduced ability to formulate plans

• Re-enactment of the trauma

3. TYPES OF TRAUMA

SHOCK TRAUMA (PTSD) results from feeling


overwhelmed by just one event. The event is usually
sudden and unexpected with a distinct beginning and
end, and it is over relatively quickly. It abruptly inter-
rupts the flow of life and you feel frozen in the event.
As a result, you feel as though your world has sudden-
ly fallen apart or shattered.

Many kinds of events can lead to shock trauma. These


include: falls, accident, assault, suffocation, acts of
war, near drowning, natural disaster, invasive medical
procedure.

Shock trauma can occur in children and adults who


witness or experience these events. An intense shock
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trauma or a series of shock traumas have the potential, however, of
becoming developmental traumas in children.

While emotional trauma is a normal response to a disturbing event,


it becomes PTSD when your nervous system gets “stuck” and you
remain in psychological shock, unable to make sense of what hap-
pened or process your emotions.

DEVELOPMENTAL TRAUMA (**) results from events that are


so overwhelming to a child that her nervous system cannot mature in
an age-appropriate manner. The disruption in her nervous system is
often great enough to cause long-lasting changes and delays in her
physical maturation, behavior and her capacity to think, handle emo-
tions and to socialize with others. If the abuse is severe and depend-
ing on the age of the child at the time of the abuse, the child’s brain
structure may be physically damaged.

Some childhood experiences that can lead to developmental trauma


include: neglect, prenatal or perinatal trauma, loss of a significant
person during the early childhood years, physical, sexual or emotion-
al abuse.

The abuse, neglect or loss impairs how a child bonds or attaches to


her caretaker and this may affect the child in two significant ways.
First, a child is born wanting to be seen and understood by her care-
taker. If this does not happen when the child is young, she may give
up all attempts to reach out to others. She collapses inwardly, be-
comes emotionally numb or dissociated.

Second, a child’s nervous system, up until the age of two, does not
have capacity to self-soothe. She must rely on a caretaker to guide
her to a calmer state. If the caretaker is unable to do so because
she is too dysregulated and frequently angry, anxious or depressed,
then the child’s brain may not develop properly. As a result, the child
grows up with a decreased capacity to control her emotions and be-
haviors. To cope, the adult may either avoid situations which provoke
strong emotions or act them out impulsively. This can lead to social
isolation or frequent conflicts with other. In conclusion, if the child
cannot trust that the caretaker will be there consistently; be there at
all; or without causing intense fear, the child will find ways to adapt to
the abusive or neglectful behavior that can seriously impair her ability
to function as an adult.

TRANSGENERATIONAL TRAUMA refers to trauma that


passes through generations. The idea is that not only can someone
experience trauma, they can then pass the symptoms and behaviors
of trauma survival on to their children, who then might further pass
these along the family line. Scientists have found that mothers who
have suffered childhood trauma can pass this memory down to an
unborn baby — scans showed altered brain circuitry in young
children.
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4. ACE QUIZ

The CDC-Kaiser Permanente’s Adverse


Childhood Experiences Study (ACE
Study) links 10 types of childhood trauma
with the adult onset of chronic disease,
mental illness, and violence.
The 10 ACEs are: physical, sexual,
emotional abuse; physical, emotional ne-
glect; living with a family member who’s
addicted to alcohol or other drugs, is
depressed, has other mental illness or
who’s imprisoned; witnessing a mother’s
abuse; divorce or separation.
For people who have four types of child- 5. HOW TRAUMA AFFECTS THE
hood adversity — an ACE score of 4 — BRAIN/NERVOUS SYSTEM (***)
alcoholism risk increases 700 percent;
attempted suicide increases 1200 per-
cent. Heart disease and cancer nearly
double. People with high ACE scores Many researchers have demonstrat-
have more marriages, more broken ed that trauma has the power to alter
bones, more depression, more prescrip- the central nervous system. It impacts
tion drug use, more obesity. how we process memory and leaves us
highly reactive to any stimuli that might
FIND YOUR ACE SCORE HERE
mimic the original experience.

The way trauma influences brain devel-


opment will be different for each person.
The following regions of the brain are
the most likely to change following a
traumatic event.

The amygdala is designed to detect and


react to people, places, and things in the
environment that could be dangerous. This is
important for safety and survival. After trauma,
the amygdala can become even more highly
attuned to potential threats in the environment,
leading a trauma victim to closely monitor their
surroundings to make sure they are safe and
have strong emotional reactions to people,
places, or things that might be threatening or
that remind them of the trauma. This height-
ened attention to potential threats in the envi-
ronment can make it hard to pay attention, go
to new places, or interact with new people.

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The medial prefrontal cortex (mPFC) helps
to control the activity of the amygdala and is
involved in learning that previously threatening
people or places are now safe. Connections
between the mPFC and amygdala are sometimes
not as strong in people who have experienced
trauma. As a result, the mPFC is not as effective
at reducing amygdala reactivity to people, places,
and things that are in fact safe and no longer pre-
dict danger. This can lead to persistent elevations
in fear and anxiety about cues that remind people
of the trauma they experienced.

The hippocampus is involved in learning and


memory. Impairments in learning and memory
have been seen in people who have experienced
trauma. This suggests that trauma may affect
how the hippocampus develops. Trauma likely
impacts a variety of types of learning and mem-
ory, such as the ability to learn and remember
information about the surrounding environment.
As a result, people who experience trauma may
not be able to retain information about how to tell
if one situation is safe and another is dangerous,
leading them to experience harmless situations
as scary. For example, a person who has expe-
rienced trauma may have difficulty distinguish-
ing between activities that are dangerous (e.g.,
walking down a dark alley) and safe (e.g., walking
around a dark corner at home).

Critically, these changes in the brain


are not permanent.

The brain is remarkably plastic, meaning that it


changes in response to social and environmen-
tal experiences. This enables us to learn, form
relationships with people, and develop new skills.
Changes in the brain that happen after trauma
can improve over time. This is particularly likely
to happen when people experience safe, stable,
and supportive environments after trauma.

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6. HEALING MODALITIES:

Below is a list of trauma-healing modalities. Many


can be used by themselves or in conjunction with
therapy. Body-based approaches are considered
more effective than cognitive therapy. They do not
focus on the past, but on present experience. They
tap into trapped trauma energy and help process
and integrate it. Our nervous system becomes bet-
ter regulated and we no longer are at the mercy of
old reactive patterns. In many modalities, titration is
an important concept: only go so far as the body-
mind can integrate, so as not to trigger re-traumati-
zation.

Somatic Experiencing—for shock trauma and PTSD.


The Somatic Experiencing® method is a body-oriented
approach to the healing of trauma and other stress dis-
orders. It is the life’s work of Dr. Peter A. Levine, result-
ing from his multidisciplinary study of stress physiology,
psychology, ethology, biology, neuroscience, indigenous
healing practices, and medical biophysics, together with
over 45 years of successful clinical application. The
SE™ approach releases traumatic shock, which is key
to transforming PTSD and the wounds of emotional and
early developmental attachment trauma.

NeuroAffective Relational Model (NARM)—for attach-


ment, relational and developmental trauma. NARM is
a cutting-edge model for addressing attachment, rela-
tional and developmental trauma, by working with the
attachment patterns that cause life-long psychobiologi-
cal symptoms and interpersonal difficulties. These early,
unconscious patterns of disconnection deeply affect our
identity, emotions, physiology, behavior and relation-
ships. Learning how to work simultaneously with these
diverse elements is a radical shift that has profound
clinical implications for healing complex trauma.

Eye Movement Desensitization and Reprocessing


(EMDR). A structured therapy that encourages the pa-
tient to briefly focus on the trauma memory while simul-
taneously experiencing bilateral stimulation (typically
eye movements), which is associated with a reduction
in the vividness and emotion associated with the trauma
memories.
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Compassionate Inquiry. Compassionate In- research. Clinical trials have shown that ingest-
quiry® is a psychotherapeutic approach de- ing a psychedelic in a carefully prescribed and
veloped by Dr. Gabor Maté that reveals what monitored setting can induce an experience
lies beneath the appearance we present to the that is medically safe and that provokes
world. Client and therapist unveil the level of profound, durable psychological and behavioral
consciousness, mental climate, hidden assump- change.
tions, implicit memories and body states that
form the real message that words both express Polyvagal theory can be integrated with
and conceal. Through Compassionate Inquiry, other modalities. Counselors who use polyvagal
the client can recognize the unconscious dy- theory, picture a defense mechanism hierarchy.
namics that run their lives and how to liberate They recognize shifts from fight-or-flight to shut-
themselves from them. down when clients feel trapped. They can also
recognize the movement from shutdown into
Emotional Freedom Technique (EFT tap- fight-or-flight that offers a possible shift into so-
ping). Emotional freedom technique (EFT) is cial engagement if and when the client can gain
an alternative treatment for physical pain and a sense of safety. Polyvagal theory deepens
emotional distress. It’s also referred to as tap- that awareness with the knowledge that playful
ping or psychological acupressure. People who arousal and restorative surrender have a
use this technique believe tapping the body can unique nervous system influence.
create a balance in your energy system and
treat pain. Though still being researched, EFT
tapping has been used to treat people with anxi-
ety and people with PTSD.

Internal Family Systems (IFS) therapy. An in-


tegrative approach to individual psychotherapy
developed by Richard C. Schwartz. It combines
systems thinking with the view that the mind is
made up of relatively discrete subpersonalities,
each with its own unique viewpoint and quali-
ties. IFS uses family systems theory to under-
stand how these collections of subpersonalities
are organized. IFS believes that our inner parts
contain valuable qualities and our core Self
knows how to heal, allowing us to become inte-
grated and whole. In IFS all parts are welcome.

Brainspotting (BSP). Brainspotting locates


points in the client’s visual field that help to
access unprocessed trauma in the subcortical
brain. The founder Dr. Grand discovered that
“Where you look affects how you feel.” It is the
brain activity, especially in the subcortical brain
that organizes itself around that eye position.

Psychedelic-assisted therapy. It refers to


therapeutic practices that involve the ingestion
of a psychedelic drug (ketamine, MDMA, psi-
locybin, Ayahuasca…). Since the early 1990s,
a new generation of scientists has revived the

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7. TOWARD A TRAUMA-INFORMED SOCIETY

The longer trauma remains untreated, the more likely it is that


our lives will become dominated by the symptoms it produces.

A trauma-informed society is the first step towards breaking


the cycles of trauma and reclaiming our authentic selves.

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Let's work together towards a more inclusive world
and a trauma-informed society where:

• We recognize the prevalence of trauma among all


of us
• We learn to notice and feel the trauma symptoms
in ourselves
• We acknowledge that whenever there is a reac-
tion, there is an old wound
• We understand the imprint of trauma on our be-
haviors and its impact on our relationships
• We recognize the pain in others and understand
how that pain might be driving their behavior
• We see the real person underneath the behavior
and the trauma
• We support connection and compassion as the
foundations of safety References
• We know that the experience of safety is the be-
ginning of healing (*) Peter Levine, Healing Trauma
(**) Maggie Kerrigan, Healing After Trauma
• We understand that all trauma is intergenerational
(***) Adapted from Katie McLaughlin,
Stress and Development Lab, University of
Washington

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